"I didn't feel that they should be closing a school due to a lice outbreak," she said.

Alfano has been in business for four years. She knows what to look for when she examines someone's head.

She and her employees search for nits. The lice eggs aren't white, like most people think, Alfano says. Rather, they are grey-brown and attached to the hair.

The lice themselves are often close by or on the scalp. A common misconception is that they live near the neck or ears, Alfano said.

"We find that in the beginning stages, a lot of clients have nits and bugs right on top of their head," she said.

Another misconception: No itching, no lice. Alfano said about half the time, lice can be present without itching.

But the biggest misconception parents have is that they have tear through their homes, eliminating every last louse. Lice won't survive long unless they're on our heads, drinking our blood.

Head to Head charges $165 to $245 to remove lice, depending on how long it takes (usually 90 minutes to two hours). But the business also sells professional lice combs and hair products for parents who want to tackle the problem themselves.

Aside from treatment, Alfano fields countless emails and calls about lice. She gives presentations for school nurses and pediatricians, her top referrers.

"When they perform school head checks for kids, when they give the right information to the parent it's not as overwhelming," Alfano said. "The more knowledge school nurses have, the better they can help parents."

Alfano also tries to reduce the stigma surrounding lice.

"We explain to our clients that they shouldn't be embarrassed," she said. "It's a sign of love. If their kids weren't close to other children, they wouldn't have it."